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NPI Code Detail

MEDICARE: DONELSON EYECARE, PLLC

MEDICARE: DONELSON EYECARE, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist
2152WC0802XCorneal and Contact Management Optometrist
3332H00000XEyewear Supplier
4152W00000XOptometrist1459TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548302854
Entity Type Code : Organization
Provider Name (Legal Business Name) : DONELSON EYECARE, PLLC
Provider Business Mailing Address
First Line : 3252 ASPEN GROVE DR STE 1
Second Line :
City : FRANKLIN
State : TN
Zip : 37067-4894
Country : US
Telephone Number : 615-786-9044
Fax Number : 615-905-4655
Provider Business Practice Location Address
First Line : 2378 LEBANON PIKE
Second Line :
City : NASHVILLE
State : TN
Zip : 37214-2411
Country : US
Telephone Number : 615-889-0147
Fax Number : 615-889-2700
Authorized Official
Title or Position : PRESIDENT
Name : JEFFREY L KEGARISE
Credential : OD
Telephone Number : 615-771-7555
Provider Enumeration Date : 02/13/2007
Last Update Date : 07/31/2024

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Directions to “DONELSON EYECARE, PLLC ” Practice Location

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